Plastic Surgeons Group Calls for Delaying Gender‑Affirming Surgery Until Age 19

The American Society of Plastic Surgeons, the largest professional body for plastic surgeons in the U.S., issued a new recommendation urging physicians to delay gender‑affirming surgeries for minors until they reach at least 19 years of age, citing limited evidence of long‑term benefits and concerns about potential risks.

By David Thompson – News Reporter

Last Updated: Feb. 2, 2026

New Position from Leading Plastic Surgeons Group

The American Society of Plastic Surgeons (ASPS) announced that it recommends waiting until patients turn 19 before performing gender‑affirming procedures, including chest, genital and facial surgeries for transgender and nonbinary youth. The group said it found ‘insufficient evidence’ that the benefits of these surgeries for minors outweigh the potential risks, particularly given the irreversible nature of the procedures and ongoing uncertainties in clinical research. This marks a shift in the organization’s stance on the highly debated topic. :contentReference[oaicite:1]{index=1}

Scientific Evidence and Rationale Cited

In its position statement, ASPS referenced the Cass Review — a controversial analysis led by a senior UK doctor — and a 2025 U.S. Department of Health and Human Services report as key sources informing its view that long‑term benefits for minors remain unclear. The organization emphasized that its guidance is intended to balance compassion for young patients with ‘scientific rigor, developmental considerations and concern for long‑term welfare,’ and explicitly noted that the statement is not a clinical guideline requiring adherence by all surgeons. :contentReference[oaicite:2]{index=2}

Divergence from Other Medical Groups

ASPS’s recommendation diverges from the positions of other major medical associations. Groups such as the American Academy of Pediatrics and the World Professional Association for Transgender Health (WPATH) have generally supported more individualized, case‑by‑case approaches to gender‑affirming care for adolescents without a hard age cutoff. Those organizations argue that decisions should be made jointly by knowledgeable clinicians, patients and families, based on comprehensive evaluations rather than fixed age thresholds. :contentReference[oaicite:3]{index=3}

Context of Federal Policy Pressure

The change in guidance comes against a backdrop of heightened federal policy activity under the Trump administration, which has increasingly pressured health care providers to limit or restrict gender‑affirming care for minors. Officials from the U.S. Department of Health and Human Services have praised ASPS’s stance as aligning with efforts to prioritize ‘biological truth,’ while legal threats and regulatory uncertainty have led some hospitals to halt or suspend services for transgender youth. :contentReference[oaicite:4]{index=4}

Debate and Clinical Uncertainties

Experts emphasize that gender‑affirming surgery for minors has been rare in the United States, and current research continues to grapple with questions about long‑term outcomes, psychological impacts, and the developmental implications of irreversible interventions during adolescence. While ASPS’s recommendation focuses on surgical procedures, broader discussions continue about the role of puberty blockers, hormone therapy and comprehensive mental health support in treating gender dysphoria. Debates remain intense among clinicians, advocacy groups and policymakers. :contentReference[oaicite:5]{index=5}